| NPI | 1194797506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OH 010701) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 010701) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2014-01-02 |